Trial application of a model of resource utiliztion, costs, and outcomes for stroke (MORUCOS) to assist priority setting in stroke.

Moodie, Marjory, Carter, Rob, Mihalopoulos, Cathy, Thrift, Amanda G., Chambers, Brian R., Donnan, Geoffrey A. and Dewey, Helen M. 2004, Trial application of a model of resource utiliztion, costs, and outcomes for stroke (MORUCOS) to assist priority setting in stroke., Stroke, vol. 35, pp. 1041-1046.

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Title Trial application of a model of resource utiliztion, costs, and outcomes for stroke (MORUCOS) to assist priority setting in stroke.
Author(s) Moodie, Marjory
Carter, Rob
Mihalopoulos, Cathy
Thrift, Amanda G.
Chambers, Brian R.
Donnan, Geoffrey A.
Dewey, Helen M.
Journal name Stroke
Volume number 35
Start page 1041
End page 1046
Publisher Lippincott Williams & Wilkins
Place of publication Philadelphia, PA
Publication date 2004-03-18
ISSN 0039-2499
1524-4628
Keyword(s) cerebrovascular disorders
cost-benefit analysis
aspirin
thrombolytic therapy
Summary Background and Purpose— Cost-effectiveness data for stroke interventions are limited, and comparisons between studies are confounded by methodological inconsistencies. The aim of this study was to trial the use of the intervention module of the economic model, a Model of Resource Utilization, Costs, and Outcomes for Stroke (MORUCOS) to facilitate evaluation and ranking of the options.

Methods— The approach involves using an economic model together with added secondary considerations. A consistent approach was taken using standard economic evaluation methods. Data from the North East Melbourne Stroke Incidence Study (NEMESIS) were used to model "current practice" (base case), against which 2 interventions were compared. A 2-stage process was used to measure benefit: health gains (expressed in disability-adjusted life years [DALYs]) and filter analysis. Incremental cost-effectiveness ratios (ICERs) were calculated, and probabilistic uncertainty analysis was undertaken.

Results— Aspirin, a low-cost intervention applicable to a large number of stroke patients (9153 first-ever cases), resulted in modest health benefits (946 DALYs saved) and a mean ICER (based on incidence costs) of US $1421 per DALY saved. Although the health gains from recombinant tissue-type plasminogen activator (rtPA) were less (155 DALYs saved), these results were impressive given the small number of persons (256) eligible for treatment. rtPA dominates current practice because it is more effective and cost-saving.

Conclusions— If used to assess interventions across the stroke care continuum, MORUCOS offers enormous capacity to support decision-making in the prioritising of stroke services.


Notes published online Mar 18, 2004
Language eng
Field of Research 110904 Neurology and Neuromuscular Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, American Heart Association, Inc.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30004106

Document type: Journal Article
Collection: School of Health and Social Development
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